WO2019161363A1 - Systèmes chirurgicaux et procédés d'identification d'outils guidés par des robots chirurgicaux - Google Patents

Systèmes chirurgicaux et procédés d'identification d'outils guidés par des robots chirurgicaux Download PDF

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Publication number
WO2019161363A1
WO2019161363A1 PCT/US2019/018500 US2019018500W WO2019161363A1 WO 2019161363 A1 WO2019161363 A1 WO 2019161363A1 US 2019018500 W US2019018500 W US 2019018500W WO 2019161363 A1 WO2019161363 A1 WO 2019161363A1
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WIPO (PCT)
Prior art keywords
tool
checkpoint
surgical
set forth
surgical system
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PCT/US2019/018500
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English (en)
Inventor
Zenan ZHANG
Kevin Bechtold
Carl Gayle
Original Assignee
Mako Surgical Corp.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Mako Surgical Corp. filed Critical Mako Surgical Corp.
Priority to EP19712325.0A priority Critical patent/EP3755259A1/fr
Priority to AU2019222578A priority patent/AU2019222578A1/en
Publication of WO2019161363A1 publication Critical patent/WO2019161363A1/fr

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10Computer-aided planning, simulation or modelling of surgical operations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361Image-producing devices, e.g. surgical cameras
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/90Identification means for patients or instruments, e.g. tags
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/34Acetabular cups
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2051Electromagnetic tracking systems
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2055Optical tracking systems
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2055Optical tracking systems
    • A61B2034/2057Details of tracking cameras
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2063Acoustic tracking systems, e.g. using ultrasound
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2068Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis using pointers, e.g. pointers having reference marks for determining coordinates of body points
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2068Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis using pointers, e.g. pointers having reference marks for determining coordinates of body points
    • A61B2034/207Divots for calibration
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2074Interface software
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/25User interfaces for surgical systems
    • A61B2034/252User interfaces for surgical systems indicating steps of a surgical procedure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/25User interfaces for surgical systems
    • A61B2034/256User interfaces for surgical systems having a database of accessory information, e.g. including context sensitive help or scientific articles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4607Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of hip femoral endoprostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4632Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery

Definitions

  • Surgical robots are frequently used to assist medical professionals in carrying out various conventional surgical procedures.
  • a surgeon may use a surgical robot to guide, position, move, actuate, or otherwise manipulate various tools, components, prostheses, and the like during surgery.
  • surgical robots can be used to assist surgeons in performing a number of different types of surgical procedures.
  • surgical robots are commonly used in procedures involving the correction, resection, or replacement of degenerated joints to help improve patient mobility and reduce pain.
  • hip replacement procedures the surgeon replaces portions of the patient's hip joint with artificial prosthetic components.
  • total hip arthroplasty the surgeon typically removes portions of the patient’s femur to accommodate a prosthetic femoral component comprising a head, and resurfaces the acetabulum of the pelvis with a reamer to facilitate installing a prosthetic cup shaped to receive the head of the prosthetic femoral component.
  • the surgeon may attach different types of tools to the surgical robot to help facilitate approaching the surgical site, removing portions of joints and/or bone, installing prosthetic components, and the like.
  • an end effector which supports a reamer tool may be used to resurface the acetabulum of the pelvis
  • an end effector which supports an impactor tool may be used to facilitate installing the prosthetic cup into the reamed acetabulum of the pelvis.
  • the surgical robot helps keep the reamer tool and the impactor tool aligned relative to the surgical site along a trajectory, and the surgeon closely monitors the trajectory and depth of reaming and impacting to ensure proper installation and alignment of the cup into the reamed acetabulum.
  • a reamer toolset may comprise different sizes, shapes, and/or styles of reamer tools for the surgeon to select from for a particular surgical procedure
  • an impactor toolset may comprise different sizes, shapes, and/or styles of impactor tools for the surgeon to select from for a particular surgical procedure.
  • the surgeon generally needs to input the selected tool’s identity into one or more controllers in communication with the surgical robot so that the surgical robot can properly maintain the position, orientation, and/or trajectory of the tool with respect to the surgical site.
  • the process of properly inputting the identity of the selected tool into the controller takes time and may be susceptible to human error, such as where a toolset comprises a large number of visually-similar tools.
  • the present disclosure provides a surgical system for assisting a user in performing a surgical procedure at a surgical site.
  • the surgical system comprises a tool having a checkpoint feature, a pointer having a distal tip, and a localizer to determine a position of the pointer within a field of view.
  • a memory is provided comprising identification data associated with a plurality of tools.
  • the controller is configured to prompt the user to position the distal tip of the pointer at the checkpoint feature of the tool.
  • the controller is also configured to receive position data from the localizer associated with the pointer within the field of view, and to compare position data associated with the pointer against the identification data of the memory to determine an identity of the tool.
  • the controller is also configured to present the user with the identity of the tool.
  • the present disclosure also provides a toolset for driving a workpiece at a surgical site along a trajectory maintained by a surgical robot having a reference point.
  • the toolset comprises a mount adapted to attach to the surgical robot, and a guide coupled to the mount and comprising a receiver.
  • the toolset also comprises first and second tools.
  • the first tool has a first working end to support the workpiece, a first coupling to engage the receiver of the guide, and a first tool body extending between the first working end and the first coupling with a first checkpoint feature arranged at a first predetermined location defined with respect to the reference point when the first coupling is engaged with the receiver and the mount is attached to the surgical robot.
  • the second tool has a second working end to support the workpiece, a second coupling to engage the receiver of the guide, and a second tool body extending between the second working end and the second coupling with a second checkpoint feature arranged at a second predetermined location, different from the first predetermined location, defined with respect to the reference point when the second coupling is engaged with the receiver and the mount is attached to the surgical robot.
  • the present disclosure also provides a method of assisting a user in performing a surgical procedure with a surgical system comprising a surgical robot, a localizer, and a monitor.
  • the method comprises: attaching a tool having a checkpoint feature to the surgical robot, and sending a first interface image to the monitor prompting the user to position a distal tip of the pointer at the checkpoint feature of the tool.
  • the method also comprises tracking the pointer with the localizer to determine position data associated with the pointer, identifying the tool by comparing the position data from the localizer with stored identification data, and sending a second interface image to the monitor presenting the user with the identity of the tool.
  • Figure 1 is a perspective view of a surgical system comprising a surgical robot with a robotic arm supporting an end effector to which a tool is supported along a trajectory adjacent to a surgical site on a patient’s body, and shown with a pointer, a localizer, and a monitor adjacent to the surgical robot.
  • Figure 2 is a schematic diagram of the surgical system shown having a controller in communication with the surgical robot, the localizer, and the monitor of Figure 1.
  • Figure 3A is an exemplary first interface image to be displayed on the monitor of Figures 1-2, shown prompting a surgeon to place a distal top of the pointer of Figure 1 in a divot formed in an end effector tool realized as a reamer.
  • Figure 3B is an exemplary second interface image to be displayed on the monitor of Figures 1-2, shown presenting an identity of the reamer tool.
  • Figure 3C is an exemplary third interface image to be displayed on the monitor of Figures 1-2, shown presenting an identity of the reamer tool alongside identities associated with other reamer tools of one toolset.
  • Figure 4A is another exemplary first interface image to be displayed on the monitor of Figures 1-2, shown prompting a surgeon to place a distal top of the pointer of Figure 1 in a divot formed in an end effector tool realized as an impactor.
  • Figure 4B is another exemplary second interface image to be displayed on the monitor of Figures 1-2, shown presenting an identity of the impactor tool.
  • Figure 4C is another exemplary third interface image to be displayed on the monitor of Figures 1-2, shown presenting an identity of the impactor tool alongside identities associated with other impactor tools of another toolset.
  • Figure 5A is a perspective view of an end effector with a tool realized as a straight impactor for use with the surgical system of Figure 1.
  • Figure 5B is a partial, enlarged perspective view taken about indicia 5B in Figure 5A, showing checkpoint features realized as divots (one divot shown in phantom) arranged about a circular checkpoint space.
  • Figure 6A is a perspective view of an end effector with a tool realized as a first- option impactor for use with the surgical system of Figure 1.
  • Figure 6B is a partial, enlarged perspective view taken about indicia 6B in Figure 6A, showing a checkpoint feature realized as a divot (partially shown in phantom) arranged about a circular checkpoint space.
  • Figure 7A is a perspective view of an end effector with a tool realized as a second-option impactor for use with the surgical system of Figure 1.
  • Figure 7B is a partial, enlarged perspective view taken about indicia 7B in Figure 7A, showing checkpoint features realized as divots (one divot shown in phantom) arranged about a circular checkpoint space.
  • Figure 8 is a perspective view of an end effector depicted in phantom, shown with the circular checkpoint spaces of Figures 5B, 6B, and 7B spaced from each other and from a reference point.
  • Figure 9A is a perspective view of an end effector with a tool realized as a straight reamer for use with the surgical system of Figure 1.
  • Figure 9B is a partial, enlarged perspective view taken about indicia 9B in Figure 9A, showing checkpoint features realized as divots (one divot shown in phantom) arranged about a circular checkpoint space.
  • Figure 10A is a perspective view of an end effector with a tool realized as a first- option reamer for use with the surgical system of Figure 1.
  • Figure 10B is a partial, enlarged perspective view taken about indicia 10B in Figure 10 A, showing checkpoint features realized as divots (one divot shown in phantom) arranged about a circular checkpoint space.
  • Figure 11A is a perspective view of an end effector with a tool realized as a second-option reamer for use with the surgical system of Figure 1, the second-option reamer shown arranged in a first orientation.
  • Figure 11B is a partial, enlarged perspective view taken about indicia 11B in Figure 11 A, showing checkpoint features realized as divots (one divot shown in phantom) arranged along respective radial arc checkpoint spaces.
  • Figure 12A is another perspective view of the end effector and second-option reamer of Figures 11 A-l 1B, shown arranged in a second orientation.
  • Figure 12B is a partial, enlarged perspective view taken about indicia 12B in Figure 12 A, showing the checkpoint features realized as divots (one divot shown in phantom) arranged along respective radial arc checkpoint spaces.
  • Figure 13 A is another perspective view of the end effector and second-option reamer of Figures 11 A-12B, shown arranged in a third orientation.
  • Figure 13B is a partial, enlarged perspective view taken about indicia 13B in Figure 13 A, showing the checkpoint features realized as divots (one divot shown in phantom) arranged along respective radial arc checkpoint spaces.
  • Figure 14 is a perspective view of an end effector depicted in phantom, shown with the circular checkpoint spaces of Figures 9B and 10B and the radial arc checkpoint spaces of Figures 11B, 12B, and 13B spaced from each other and from a reference point.
  • a surgical system 30 comprising a surgical robot 32 is shown in Figure 1.
  • the surgical robot 32 has a base 34, a robotic arm 36, and a coupler 38.
  • the robotic arm 36 is supported by the base 34 and is configured to move, drive, maintain, or otherwise control the position and/or orientation of the coupler 38 relative to the base 34 during use.
  • the coupler 38 is adapted to releasably secure an end effector 40 which, in turn, supports a tool, generally indicated at 42.
  • the tool 42 is configured to support, position, or otherwise facilitate driving a workpiece, depicted generically at 44 in Figure 1, at a surgical site ST on a patient’s body B along a trajectory T maintained by the surgical robot 32.
  • the surgical robot 32 moves the workpiece 44, the tool 42, and the end effector 40 via the robotic arm 36 to, among other things, assist medical professionals in carrying out various types of surgical procedures with precise control over movement and positioning of the end effector 40, the tool 42, and the workpiece 44.
  • One exemplary arrangement of the robotic arm 36 is described in U.S. Patent No. 9,119,655, entitled, “Surgical Robotic arm Capable of Controlling a Surgical Instrument in Multiple Modes,” the disclosure of which is hereby incorporated by reference in its entirety.
  • the tool 42 and/or the workpiece 44 could be of a number of different styles, types, and/or configurations, depending on the specific surgical procedure being performed.
  • surgical procedures such as total hip arthroplasty routinely involve the use of multiple tools 42 to facilitate approaching the surgical site ST, preparing the surgical site ST, and/or installing implants (e.g., prosthetic components), and the like at the surgical site ST.
  • one tool 42 could be a reamer used to facilitate preparing the acetabulum by driving a workpiece 44 realized as a reamer head (not shown in detail), and another tool 42 could be an impactor used to facilitate implanting a workpiece 44 realized as a prosthesis (not shown).
  • the Applicant has described these types of reaming, preparing, and impaction processes in greater detail in U.S. Patent Nos. 8,979,859 and 8,753,346, the disclosures of which are hereby incorporated by reference in their entirety.
  • the surgical system 30 is able to monitor, track, and/or determine changes in the relative position and/or orientation of one or more parts of the surgical robot 32, the robotic arm 36, the end effector 40, the tool 42, and/or the workpiece 44, as well as various parts of the patient’s body B, within a common coordinate system by utilizing various types of trackers (e.g., multiple degree-of-freedom optical, inertial, and/or ultrasonic sensing devices), navigation systems (e.g., machine vision systems, charge coupled device cameras, tracker sensors, surface scanners, and/or range finders), anatomical computer models (e.g., magnetic resonance imaging scans of the patient’s anatomy), data from previous surgical procedures and/or previously- performed surgical techniques (e.g., data recorded while reaming the acetabulum that are subsequently used to facilitate impacting the prosthesis), and the like.
  • trackers e.g., multiple degree-of-freedom optical, inertial, and/or ultrasonic sensing devices
  • the surgical system 30 generally comprises a controller 46, a memory 48 comprising identification data ID and interface images IM, a pointer 50 having a distal tip 50D, a robotic control system 52, and a navigation system 54 which cooperate to allow the surgical robot 32 maintain alignment of the tool 42 along the trajectory T.
  • a controller 46 a memory 48 comprising identification data ID and interface images IM
  • a pointer 50 having a distal tip 50D
  • a robotic control system 52 having a distal tip 50D
  • a navigation system 54 which cooperate to allow the surgical robot 32 maintain alignment of the tool 42 along the trajectory T.
  • the controller 46 is disposed in communication with the robotic control system 52 and the navigation system 54, such as via wired or wireless electronic communication.
  • the controller 46 either communicates with or is realized by a robot controller 56 and/or a navigation controller 58, as described in greater detail below.
  • the robot controller 56 forms part of the robotic control system 52
  • the navigation controller 58 forms part of the navigation system 54.
  • the controller 46, the robot controller 56, and/or the navigation controller 58 may be realized as computers, processors, control units, and the like, and may be discrete components, may be integrated, and/or may otherwise share hardware, software, inputs, outputs, and the like.
  • the surgical system 30 employs the robotic control system 52 to, among other things, articulate the robotic arm 36, maintain the trajectory T, and the like.
  • the robot controller 56 of the robotic control system 52 is configured to articulate the robotic arm 36 by driving various actuators, motors, and the like disposed at joints of the robotic arm 36 (not shown).
  • the robot controller 56 also gathers data from various sensors such as encoders located along the robotic arm 36 (not shown). Because the specific geometry of each of the components of the surgical robot, end effector 40, and tools 42 are known, these sensor data can be used by the robot controller 56 to reliably adjust the position and/or orientation of the end effector 40 and the tool 42 within a manipulator coordinate system MNPL (see Figure 1).
  • the manipulator coordinate system MNPL has an origin, and the origin is located relative to the robotic arm 36.
  • This type of manipulator coordinate system MNPL is described in U.S. Patent No. 9,119,655, entitled,“Surgical Robotic Arm Capable of Controlling a Surgical Instrument in Multiple Modes,” previously referenced.
  • the surgical system 30 employs the navigation system 54 to, among other things, track movement of various objects such as the end effector 40, the pointer 50, and parts of the patient’s body B (e.g. bones or other anatomy at the surgical site ST).
  • the navigation system 54 employs a localizer 60 configured to sense the position and/or orientation of trackers 62 fixed to objects within a localizer coordinate system LCLZ.
  • the navigation controller 58 is disposed in communication with the localizer 60 and gathers position and/or orientation data for each tracker 62 sensed within a field of view FV of the localizer 60 in the localizer coordinate system LCLZ.
  • the localizer 60 is configured to determine a position of the tool 42 within the field of view FV.
  • the localizer 60 can sense the position and/or orientation of multiple trackers 62 to track correspondingly multiple objects within the localizer coordinate system LCLZ.
  • trackers 62 may comprise a pointer tracker 62P coupled to the pointer 50, an end effector tracker 62E coupled to the end effector 40, a first patient tracker 62A, and/or a second patient tracker 62B, as well as additional patient trackers, trackers for additional medical and/or surgical tools, and the like.
  • the end effector tracker 62E is firmly affixed to the end effector 40
  • the first patient tracker 62A is firmly affixed to one bone of the patient’s body B at the surgical site ST (e.g., to the pelvis adjacent to the acetabulum)
  • the second patient tracker 62B is firmly affixed to a different bone (e.g., to the femur adjacent to the head).
  • the end effector tracker 62E could be fixed to the end effector 40 in different ways, such as by integration into the end effector 40 during manufacture or by releasable attachment to the end effector 40.
  • the patient trackers 62A, 62B are firmly affixed to different bones in the patient’s body B, such as by threaded engagement, clamping, or by other techniques. It will be appreciated that various trackers 62 may be firmly affixed to different types of tracked objects (e.g., discrete bones, tools, pointers, and the like) in a number of different ways.
  • the position of the trackers 62 relative to the anatomy to which they are attached can be determined by known registration techniques, such as point-based registration in which the distal tip 50D of the pointer 50 is used to touch off on bony landmarks on bone or to touch off on several points across the bone for surface-based registration as the localizer 60 monitors the position and orientation of the pointer tracker 62P.
  • Conventional registration techniques can then be employed to correlate the pose of the patient trackers 62A, 62B to the patient’s anatomy (e.g., to each of the femur and acetabulum).
  • patient trackers 62A, 62B with mechanical clamps that attach to bone and have tactile sensors (not shown) to determine a shape of the bone to which the clamp is attached. The shape of the bone can then be matched to a 3D model of bone for registration.
  • a known relationship between the tactile sensors and the three or more markers on the patient tracker 62A, 62B may be entered into or otherwise known by the navigation controller 58. Based on this known relationship, the positions of the markers relative to the patient’s anatomy can be determined.
  • Position and/or orientation data may be gathered, determined, or otherwise handled by the navigation controller 58 using conventional registration/navigation techniques to determine coordinates of each tracker 62 within the localizer coordinate system LCLZ. These coordinates are communicated to the robotic control system 52 to facilitate articulation of the robotic arm 36 and/or to otherwise assist the surgeon in performing the surgical procedure, as described in greater detail below.
  • the robot controller 56 is operatively attached to the surgical robot 32, and the navigation controller 58, the localizer 60, the controller 46, and the memory 48 are supported on a mobile cart 64 which is movable relative to the base 34 of the surgical robot 32.
  • the mobile cart 64 also supports a user interface, generally indicated at 66, to facilitate operation of the surgical system 30 by displaying information to, and/or by receiving information from, the surgeon or another user.
  • the user interface 66 is disposed in communication with the controller 46, the memory 48, the navigation system 54, and/or the robotic control system 52, and may comprise one or more output devices 68 (e.g., monitors, indicators, display screens, and the like) to present information to the surgeon (e.g., images, video, data, a graphics, navigable menus, and the like), and one or more input devices 70 (e.g., buttons, touch screens, keyboards, mice, gesture or voice-based input devices, and the like).
  • output devices 68 e.g., monitors, indicators, display screens, and the like
  • input devices 70 e.g., buttons, touch screens, keyboards, mice, gesture or voice-based input devices, and the like.
  • the user interface 66 comprises an output device 68 realized as a monitor 68M to display interface images IM, as described in greater detail below.
  • an output device 68 realized as a monitor 68M to display interface images IM, as described in greater detail below.
  • One type of mobile cart 64 and user interface 66 is described in U.S. Patent No. 7,725,162, entitled“Surgery System,” the disclosure of which is hereby incorporated by reference in its entirety.
  • the surgical system 30 transforms the coordinates of each tracker 62 within the field of view FV from the localizer coordinate system LCLZ into the manipulator coordinate system MNPL, or vice versa, so that articulation of the robotic arm 36 can be performed based at least partially on the relative positions and orientations of each tracker 62 within a single, common coordinate system (the manipulator coordinate system MNPL, the localizer coordinate system LCLZ, or another common coordinate system). It will be appreciated that coordinates within the localizer coordinate system LCLZ can be transformed into coordinates within the manipulator coordinate system MNPL, and vice versa, using a number of different conventional coordinate system transformation techniques.
  • the localizer 60 is an optical localizer and includes a camera unit 72 with one or more optical position sensors 74.
  • the navigation system 54 employs the optical position sensors 74 of the camera unit 72 to sense the position and/or orientation of the trackers 62 within the localizer coordinate system LCLZ.
  • the trackers 62 each employ markers 76 which can be sensed by the optical position sensors 74 of the camera unit 72.
  • a navigation system 54 of this type is described in U.S. Patent No. 9,008,757, entitled,“Navigation System Including Optical and Non-Optical Sensors,” the disclosure of which is hereby incorporated by reference in its entirety.
  • the markers 76 are active markers (e.g., light emitting diodes “LEDs”) which emit light that is sensed by the optical position sensors 74.
  • the markers 76 may be passive markers (e.g., reflectors) which reflect light emitted from the camera unit 72 or another light source. It should be appreciated that other suitable tracking systems and methods not specifically described herein may be utilized (e.g., ultrasonic, electromagnetic, radio frequency, and the like).
  • the surgical system 30 is capable of displaying a virtual representation of the relative positions and orientations of tracked objects to the surgeon or other users of the surgical system 30, such as with images and/or graphical representations of the anatomy of the patient’s body B, the end effector 40, and/or the tool 42 presented on one or more output devices 68, such as the monitor 68M.
  • the controller 46, the robot controller 56, and/or navigation controller 58 may also utilize the user interface 66 to display instructions or request information such that the surgeon or other users may interact with the robotic control system 52 to facilitate articulation of the robotic arm 36.
  • the controller 46 is configured to send different interface images IM stored in the memory 48 to the monitor 68M as described in greater detail below. Other configurations are contemplated.
  • the robotic control system 52 and the navigation system 54 can cooperate to facilitate control over the position and/or orientation of the end effector 40 and/or tool 42 in different ways.
  • the robot controller 56 is configured to control the robotic arm 36 (e.g., by driving joint motors) to provide haptic feedback to the surgeon via the robotic arm 36.
  • haptic feedback helps constrain or inhibit the surgeon from manually moving the end effector 40 and/or tool 42 beyond predefined virtual boundaries associated with the surgical procedure (e.g., to maintain alignment of the tool 42 along the trajectory T).
  • haptic feedback helps constrain or inhibit the surgeon from manually moving the end effector 40 and/or tool 42 beyond predefined virtual boundaries associated with the surgical procedure (e.g., to maintain alignment of the tool 42 along the trajectory T).
  • the surgical system 30 is the RIOTM Robotic Arm Interactive Orthopedic System manufactured by MAKO Surgical Corp. of Fort Lauderdale, FL, USA.
  • the surgical system 30 employs the end effector 40 to position the tool 42 at the surgical site ST along the trajectory T maintained by the surgical robot 32 to assist the surgeon in carrying out various types of surgical procedures with precise control over the relative position and orientation of the workpiece 44 attached to the tool 42 with respect to the patient’s body B.
  • the surgical robot 32 employs the end effector 40 to position the tool 42 at the surgical site ST along the trajectory T maintained by the surgical robot 32 to assist the surgeon in carrying out various types of surgical procedures with precise control over the relative position and orientation of the workpiece 44 attached to the tool 42 with respect to the patient’s body B.
  • different types of surgical procedures routinely involve the use of a number of different types of surgical devices, tools, and the like.
  • different end effectors 40 and/or tools 42 of various types, sizes, and/or configurations, may be utilized during a single surgical procedure.
  • the surgical system 30 is configured so as to allow the surgeon to attach different types of end effectors 40 and/or tools 42 to the coupler 38 of the surgical robot 32, and also to allow the surgeon to select between variations of the same type of end effector 40 and/or tool 42.
  • the surgical system 30 comprises first and second toolsets 78A, 78B, each of which includes first, second, and third tools 42 which, as described in greater detail below, are variations of the same general type of tool 42.
  • Figures 5A-8 generally depict the first toolset 78A, which includes first, second, and third variations of tools 42 configured as impactors: a straight impactor 80 (see Figures 5A- 5B), a first-option impactor 82 (see Figures 6A-6B), and a second-option impactor 84 (see Figures 7A-7B).
  • Figures 9A-14 generally depict the second toolset 78B, which includes first, second, and third variations of tools 42 configured as reamers: a straight reamer 86 (see Figures 9A-9B), a first-option reamer 88 (see Figures 10A-10B), and a second-option reamer 90 (see Figures 11A-13B).
  • first and second toolsets 78A, 78B illustrated and described herein, as well as the variations 80, 82, 84; 86, 88, 90 of tools 42 in the toolsets 78A, 78B, are exemplary and non-limiting.
  • the present disclosure is directed toward an impactor toolset 78A and a reamer toolset 78B each having three variations 80, 82, 84; 86, 88, 90 of tools 42
  • the surgical system 30 could comprise any suitable number of toolsets each having any suitable number of variations of tools 42 configured for use in any type of surgical procedure where surgical robots 32 are employed.
  • the variations 80, 82, 84; 86, 88, 90 of tools 42 within the toolsets 78A, 78B affords the surgeon with flexibility in carrying out different types of surgical procedures in different ways.
  • the surgeon may select a variation 80, 82, 84; 86, 88, 90 of one or more types of tools 42 to facilitate a particular approach, improve visibility of the surgical site ST, accommodate handling and/or orientation preferences, and the like.
  • variations 80, 82, 84; 86, 88, 90 of tools 42 generally position workpieces 44 (e.g., a prosthetic cup for the impactors 80, 82, 84, and a reamer head for the reamers 86, 88, 90) in different ways with respect to the coupler 38 of the surgical robot 34.
  • the controller 46 cooperates with the memory 48, the pointer 50, the localizer 60, and the monitor 68M to ensure that the surgical system 30 can distinguish between variations 80, 82, 84; 86, 88, 90 of tools 42 and thereby determine the position and orientation of the workpiece 44 based on the identity of the tool 42 being utilized.
  • the illustrated tools 42 are each configured for releasable attachment to a common end effector 40.
  • the end effector 40 is configured to releasably secure the straight impactor 80 (see Figure 5A), the first- option impactor 82 (see Figure 6A), the second-option impactor 84 (see Figure 7A), the straight reamer 86 (see Figure 9A), the first-option reamer 88 (see Figure 10A), and/or the second-option reamer 90 (see Figures 11 A, 12A, and 13A).
  • each toolset 78 A, 78B or even each individual tool 42 could be provided with its own end effector 40 in certain embodiments.
  • the end effector 40 In order to facilitate releasable attachment of the tools 42 to the end effector 40, the end effector 40 generally comprises a mount 92, a guide 94, and a receiver 96.
  • the mount 92 is adapted to releasably attach to the coupler 38 of the surgical robot 32 (see Figure 1).
  • the guide 94 is coupled to the mount 92 and comprises the receiver 96 which, in turn, is configured to releasably secure the tool 42 to the guide 94. Examples of this type of guide 94 and receiver 96 are described in U.S. Patent No. 8,753,346, previously referenced.
  • the guide 94 has a generally cylindrical region 98 which defines a tool axis TA and extends to a distal guide end 100.
  • the receiver 96 (depicted schematically as a sphere in Figures 5A and 9A) is configured to restrict movement of the tool 42 relative to the guide 94 in different ways depending on the type of tool 42.
  • the receiver 96 is generally configured to permit free rotation of the impactors 80, 82, 84 about the tool axis TA, and to permit limited translation along the tool axis TA (not shown in detail).
  • the receiver 96 is generally configured to inhibit translation of the reamers 86, 88, 90 along the tool axis TA (see Figures 5A, 6A, and 7A), to permit free rotation of the straight reamer 86 and the first-option reamer 88 about the tool axis TA (see Figures 9A and 10A), and to permit selective positioning of the second-option reamer 90 about the tool axis TA between first, second, and third orientations 01, 02, 03 (see Figures 11 A, 12A, and 13A) as described in greater detail below.
  • the tools 42 each generally comprise a respective working end 102, a proximal end 104, a coupling 106, a tool body 108, and a checkpoint feature 110.
  • the working end 102 is configured to releasably secure and support the workpiece 44 (e.g., a prosthetic cup for the impactors 80, 82, 84, and a reamer head for the reamers 86, 88, 90).
  • the workpiece 44 e.g., a prosthetic cup for the impactors 80, 82, 84, and a reamer head for the reamers 86, 88, 90.
  • the coupling 106 of the tool 42 (depicted schematically as an elongated recess in Figure 5A and as an indent in Figure 9A) is formed in the tool body 110 and is configured to engage the receiver 96 of the guide 94 of the end effector 40 to restrict or inhibit axial translation of the tool 42, as noted above.
  • the tool body 108 extends between the working end 102 and the proximal end 104, with the coupling 106 arranged adjacent to the proximal end 104.
  • the checkpoint feature 110 is generally formed in the tool body 108, and is arranged relative to a common reference point RP at a predetermined location that is specific to each tool 42, as described in greater detail below.
  • each tool 42 defines a respective workpiece axis WA, which may be coincident with the tool axis TA for some tools 42 (e.g., the straight impactor 80 depicted in Figure 5A), parallel to and offset from the tool axis TA for some tools 42 (e.g., the second-option reamer 90 depicted in Figures 11 A, 12A, and 13A), or angled with respect to the tool axis TA (e.g., the first-option reamer 88 depicted in Figure 10A).
  • the workpiece axis WA is coincident with the trajectory T maintained by the surgical robot 32.
  • the working ends 102 of the tools 42 each generally rotate and translate concurrently with their respective tool bodies 108.
  • a head (not shown) may be coupled to the proximal end 104 to receive external impact force, such as from a mallet (not shown) to translate the tool body 108 and the working end 102 relative to the guide 94 and thereby facilitate installing the prosthetic cup (not shown) at the surgical site ST.
  • a rotary instrument (not shown) may be coupled to the proximal end 104 to rotate the tool body 108 and the working end 102 relative to the guide 94 and thereby facilitate reaming (not shown) or otherwise preparing the surgical site ST for impaction.
  • the tool bodies 108 of the reamers 86, 88, 90 also comprise handles, generally indicated at 112, and may include one or more universal joints, generally indicated at 114 where the tool axis TA is not coincident with the workpiece axis WA (see Figures 10A, 11 A, 12A, and 13A).
  • the handles 112 may be grasped by the surgeon and do not rotate concurrently with the working end 102 in response to rotational torque applied to the proximal end 104.
  • the checkpoint features 110 of the reamers 86, 88, 90 are formed in the handles 112 of the tool bodies 108, as described in greater detail below.
  • the universal joints 114 are employed in the first-option reamer 88 and the second- option reamer 90 to allow the tool body 108, which may be comprised of discrete sections (not shown in detail) to rotate between the proximal end 104 and the working end 102.
  • the tools 42 within each toolset 78A, 78B each comprise one or more checkpoint features 110 formed in the tool body 108 at respective predetermined locations relative to the common reference point RP, as noted above.
  • the reference point RP is established when the coupling 106 of the tool 42 is engaged with the receiver 96 of the guide 94, and the end effector 40 is attached to the coupler 38 of the surgical robot 32.
  • the reference point RP could be defined or otherwise established in a number of different ways, because each of the exemplary tools 42 described and illustrated herein can be releasably attached to the same end effector 40, the reference point RP depicted in the drawings is located adjacent to the mount 92 of the end effector 40.
  • the surgical system 30 is able to determine the specific position and orientation of the coupler 38 of the surgical robot 32 within either coordinate system MNPL, LCLZ (e.g., via encoder data ED from the robotic arm 36 and/or via location data from the localizer 60 about the end effector tracker 62E), the location of the reference point RP is similarly known by the surgical system 30 during use.
  • the reference point RP may also be known in a tool coordinate system associated with the end effector tracker 62E, with the reference point RP being stored as a coordinate, plane, line, or the like in the tool coordinate system and capable of being tracked by virtue of tracking the end effector tracker 62E.
  • the relationship of the reference point RP to the end effector tracker 62E can be established by calibration, such as during manufacture or intraoperatively, or may be measured.
  • the surgical system 30 is configured to differentiate between the tools 42 of one or more toolsets 78 A, 78B based on the location of the checkpoint features 110 with respect to the reference point RP to, among other things, ensure proper operation of the robotic control system 52 and/or the navigation system 54 by correctly positioning the tool 42 and/or workpiece 44.
  • each tool 42 comprises one or more checkpoint features 110 arranged at predetermined locations which are unique to that particular tool 42 within its respective toolset 78A, 78B.
  • the checkpoint features 110 are realized as divots 116 formed in the respective tool bodies 108: the straight impactor 80 comprises two divots 116ISTA, 116ISTB (see Figure 5B); the first-option impactor 82 comprises one divot 116IFO (see Figure 6B); the second-option impactor 84 comprises two divots 116ISOA, 116ISOB (see Figure 7B); the straight reamer 86 comprises two divots 116RSTA, 116RSTB (see Figure 9B); the first-option reamer 88 comprises two divots 116RFOA, 116RFOB (see Figure 10B); and the second-option reamer 90 comprises two divots 116RS01, 116RS02 (see Figures 11B, 12B, and 13B).
  • the divots 116 each have a generally frustoconical profile which is shaped to receive the distal tip 50B of the pointer 50, as described in greater detail below.
  • the checkpoint features 110 could be configured in other ways, with or without the use of divots 116, sufficient to differentiate between tools 42 relative to the reference point RP.
  • the arrangement, orientation, and configuration of the divots 116 will be described for each toolset 78A, 78B separately.
  • the impactors 80, 82, 84 of the first toolset 78A are shown.
  • the straight impactor 80 is depicted in Figures 5A-5B.
  • the checkpoint feature 110 of the straight impactor 80 comprises two divots 116ISTA, 116ISTB which are each formed in the tool body 108 at respective predetermined locations relative to the reference point RP. Because the tool body 108 of the straight impactor 80 is arranged for rotation about the tool axis TA relative to the mount 92 of the end effector 40, as noted above, movement of the tool body 108 effects corresponding movement of the checkpoint feature 110 relative to the reference point RP within a predetermined checkpoint space 118.
  • the checkpoint space 118I ST is defined by a circle disposed about and concentrically aligned with the tool axis TA (see Figures 5B and 8).
  • the straight impactor 80 is rotated about the tool axis TA, its divots 116ISTA, 116ISTB will be positioned somewhere along the circular checkpoint space 118I ST.
  • the first-option impactor 82 is depicted in Figures 6A-6B.
  • the checkpoint feature 110 of the first-option impactor 82 comprises one divot 116IFO which is formed in the tool body 108 at a predetermined location relative to the reference point RP.
  • the tool body 108 of the first-option impactor 82 is arranged for rotation about the tool axis TA relative to the mount 92 of the end effector 40, movement of the tool body 108 effects corresponding movement of the checkpoint feature 110 relative to the reference point RP within a predetermined checkpoint space 118I FO defined by a circle disposed about and concentrically aligned with the tool axis TA (see Figures 6B and 8).
  • its divot 116IFO will be positioned somewhere along the circular checkpoint space 118I FO.
  • the second-option impactor 84 is depicted in Figures 7A-7B.
  • the checkpoint feature 110 of the second-option impactor 84 comprises two divots 116ISOA, 116ISOB which are each formed in the tool body 108 at respective predetermined locations relative to the reference point RP.
  • the tool body 108 of the second-option impactor 84 is arranged for rotation about the tool axis TA relative to the mount 92 of the end effector 40, movement of the tool body 108 effects corresponding movement of the checkpoint feature 110 relative to the reference point RP within a predetermined checkpoint space 118I SO defined by a circle disposed about and concentrically aligned with the tool axis TA (see Figures 7B and 8).
  • a predetermined checkpoint space 118I SO defined by a circle disposed about and concentrically aligned with the tool axis TA (see Figures 7B and 8).
  • the checkpoint space 118I ST of the straight impactor 80, the checkpoint space 118I FO of the first-option impactor 82, and the checkpoint space 118I SO of the second-option impactor 84 are each shown at their respective predetermined locations relative to the reference point RP established or otherwise defined by the end effector 40, as noted above.
  • Each of the checkpoint spaces 118I ST, 118I FO, 118I SO shown in Figure 8 are spaced from each other such that a predetermined distance 120 (or more) separates adjacent checkpoint spaces 118I ST, 118I FO, 118I SO from each other.
  • the predetermined location of the checkpoint feature 110 of each of the impactors 80, 82, 84 are arranged so as to be spaced from the checkpoint features 110 of each of the other impactors 80, 82, 84 at a minimum of the predetermined distance 120.
  • the impactors 80, 82, 84 are each arranged for rotation about the tool axis TA, it will be appreciated that the predetermined distance 120 extends in 3D space between any point along two adjacent checkpoint spaces 118I ST, 118I FO, 118I SO (see Figure 8).
  • the predetermined distance 120 is at least lOmm.
  • FIGS 9A-14 the reamers 86, 88, 90 of the second toolset 78B are shown.
  • the straight reamer 86 is depicted in Figures 9A-9B.
  • the checkpoint feature 110 of the straight reamer 86 comprises two divots 116RSTA, 116RSTB which are each formed in the tool body 108 at respective predetermined locations relative to the reference point RP.
  • the checkpoint space 118R ST is defined by a circle disposed about and concentrically aligned with the tool axis TA (see Figures 9B and 14).
  • the first-option reamer 88 is depicted in Figures 10A-10B. As shown in Figure 10B, the checkpoint feature 110 of the first-option reamer 88 comprises two divots 116RFOA, 116RFOB which are formed in the tool body 108 at respective predetermined locations relative to the reference point RP.
  • the tool body 108 of the first-option reamer 88 is arranged for rotation about the tool axis TA relative to the mount 92 of the end effector 40, movement of the tool body 108 effects corresponding movement of the checkpoint feature 110 relative to the reference point RP within a predetermined checkpoint space 118R FO defined by a circle disposed about and concentrically aligned with the tool axis TA (see Figures 10B and 14).
  • a predetermined checkpoint space 118R FO defined by a circle disposed about and concentrically aligned with the tool axis TA (see Figures 10B and 14).
  • the second-option reamer 90 is depicted in Figures 11A-13B. As shown in Figures 11B, 12B, and 13B, the checkpoint feature 110 of the second-option reamer 90 comprises two divots 116RS01, 116RS02 which are each formed in the tool body 108 at respective predetermined locations relative to the reference point RP. As noted above, the second-option reamer 90 does not freely rotate about the tool axis TA relative to the mount 92 of the end effector 40.
  • the handle 112 of the second-option reamer 90 comprises a key 122 which can be received in either a first, second, or third keyways 124 A, 124B, 124C formed in the cylindrical region 98 of the guide 94 adjacent to the distal guide end 100.
  • the surgeon can position the key 122 in the first keyway 124A to place the second-option reamer 90 in the first orientation 01 (see Figures 11A-11B), in the second keyway 124B to place the second-option reamer 90 in the second orientation 02 (see Figures 12A-12B), or in the third keyway 124C to place the second- option reamer 90 in the third orientation 03 (see Figures 13A-13B).
  • the illustrated embodiment of the second-option reamer 90 comprises different checkpoint features 110 respectively defined by the divots 116RS01, 116RS02.
  • movement between the first, second, and third orientations 01, 02, 03 effects corresponding movement of the checkpoint features 110 relative to the reference point RP within respective predetermined checkpoint spaces 118R SOA, 118R SOB each defined by a radial arc disposed about and concentrically aligned with the tool axis TA (see Figures 11B, 12B, 13B, and 14).
  • 118R SOA, 118R SOB each defined by a radial arc disposed about and concentrically aligned with the tool axis TA (see Figures 11B, 12B, 13B, and 14).
  • checkpoint features 110 of the illustrated embodiment of the second-option impactor 80 are configured such that the checkpoint spaces 118R SOA, 118R SOB are also spaced from each other at the predetermined distance 120, it is conceivable that the checkpoint spaces 118R SOA, 118R SOB could be arranged differently in some embodiments.
  • the checkpoint space 118R ST of the straight reamer 86, the checkpoint space 118R FO of the first-option reamer 88, and the checkpoint spaces 118R SOA, 118R SOB of the second-option reamer 90 are each shown at their respective predetermined locations relative to the reference point RP established or otherwise defined by the end effector 40, as noted above.
  • Each of the checkpoint spaces 118R ST, 118R FO, 118R SOA, 118R SOB shown in Figure 14 are similarly spaced from each other such that the predetermined distance 120 (or more) separates adjacent checkpoint spaces 118R ST; 118R FO; 118R SOA, 118R SOB from each other.
  • the predetermined location of the checkpoint features 110 of each of the reamers 86, 88, 90 are arranged so as to be spaced from the checkpoint features 110 of each of the other reamers 86, 88, 90 at a minimum of the predetermined distance 120.
  • the reamers 86, 88, 90 are each arranged for some form of movement about the tool axis TA (either free rotation or movement between discrete positions), it will be appreciated that the predetermined distance 120 similarly extends in 3D space between any point along two adjacent checkpoint spaces 118R ST; 118R FO; 118R SOA, 118R SOB (see Figure 14).
  • checkpoint features 110 defined by multiple divots 116 that can occupy a common checkpoint space 118
  • only a single divot 116 could be employed in some embodiments.
  • multiple checkpoint features 110 with one or more divots 116 that occupy respective checkpoint spaces 118 could also be employed.
  • Other configurations are contemplated.
  • the surgical system 30 is configured to differentiate between the tools 42 of one or more toolsets 78A, 78B based on the location of the checkpoint features 110 with respect to the reference point RP via the controller 46.
  • the controller 46 is configured to identify the tool 42 that is attached to the coupler 38 of the end effector 40 by monitoring the position and orientation of the pointer tracker 62P of the pointer 50 via the localizer 60 under certain operating conditions.
  • the controller 46 is configured to send different interface images IM (see Figures 3A-4C) stored in the memory 48 to the monitor 68M to assist the surgeon (or another user) in performing the surgical procedure.
  • the interface images IM may be static images or may be defined as a part of a dynamic, navigable graphical user interface.
  • the controller 46 is configured to send a first interface image IM1 (see Figures 3A and 4A) to the monitor 68M prompting the surgeon (or another user) to position the distal tip 50D of the pointer 50 at the checkpoint feature 110 of the tool 42 attached to the coupler 38 of the surgical robot 32.
  • controller 46 is further configured to receive position data PD (see Figure 2) from the localizer 60 associated with the pointer tracker 62P of the pointer 50 within the field of view FV, and use this position data PD in order to compare the current position of the checkpoint feature 110 against the identification data ID stored in the memory 48 to determine the identity of (or “recognize”) the tool 42.
  • position data PD see Figure 2
  • the controller 46 is further configured to receive position data PD (see Figure 2) from the localizer 60 associated with the pointer tracker 62P of the pointer 50 within the field of view FV, and use this position data PD in order to compare the current position of the checkpoint feature 110 against the identification data ID stored in the memory 48 to determine the identity of (or “recognize”) the tool 42.
  • the coordinates of the distal tip 50D of the pointer 50 relative to its pointer tracker 62P is calibrated or known to the localizer 60 or the navigation controller 58 via calibration data stored in memory and accessible by the localizer 60 and/or the navigation controller 58.
  • the localizer 60 and/or the navigation controller 58 are able to determine coordinates of the distal tip 50D of the pointer 50 in the localizer coordinate system LCLZ, the manipulator coordinate system MNPL, the tool coordinate system (via transformation techniques described above), or in some other common coordinate system.
  • Current coordinates of the reference point RP can similarly be determined using position data PD associated with the end effector tracker 62E.
  • coordinates of the reference point RP relative to the end effector tracker 62E can be calibrated or known to the localizer 60 or the navigation controller 58 via calibration data stored in memory and accessible by the localizer 60 and/or the navigation controller 58.
  • the localizer 60 and/or the navigation controller 58 can compare the relationship (e.g., positional relationship between coordinates) of the reference point and the checkpoint feature 110 and compare this relationship to stored, expected relationships for each of the different tools 42, e.g., the identification data ID.
  • the identification data ID associated with the tools 42 and stored in the memory 48 comprise coordinates of the predetermined locations associated with the checkpoint features 110 of each tool 42 within the respective toolset 78A, 78B. More specifically, the identification data ID may comprise coordinates and/or areas disposed along the checkpoint spaces 118 of each tool 42 within the respective toolset 78 A, 78B, and relative to the reference point RP. In some cases, these coordinates and/or areas, along with the coordinates of the reference point RP, can be stored in the tool coordinate system to establish a known relationship between the reference point RP and the checkpoints 110 and/or checkpoint spaces 118.
  • the actual coordinates of the checkpoint 110 determined by the pointer 50 can be determined in the tool coordinate system (e.g., via transformation techniques described above), compared to the stored, possible coordinates of the checkpoint 110 in the tool coordinate system, with the best fit selected to thereby identify the correct tool 42. If no match is found because the measured coordinates differ beyond a predetermined threshold from each of the stored coordinates, then the surgeon may be prompted with instructions on the monitor 68M to recalibrate the pointer 50 or to ensure that the tool 42 is fully seated in the receiver 96.
  • the controller 46 sends a second interface image IM2 (see Figures 3B and 4B) to the monitor 68M to present the surgeon (or another user) with the identity of the tool 42.
  • the controller 46 is further configured to send a third interface image IM3 (see Figures 3C and 4C) to the monitor 68M to present the surgeon (or another user) with the identity of the tool 42 alongside a predetermined number of identities associated with the other tools 42 in the respective toolset 78A, 78B based on the identification data ID stored in the memory 48.
  • the second interface image IM2 presents the identity of the tool 42 as a selection of a“drop down” list of identities (see Figures 3C and 4C). It will be appreciated that this configuration affords advantages in situations where the localizer 60 operates with less than optimal accuracy, such as where the field of view FV is narrow or obscured, where user error places the distal tip 50D of the pointer 50 out of alignment with the pointer tracker 62P, and the like.
  • the surgical system 30 could still be configured to present the surgeon (or another user) with the assumed identity of the tool 42 while, at the same time, requesting the surgeon to manually verify the identity of the tool 42 and notifying the surgeon to check for misalignment or to use a different pointer 50.
  • Other configurations are contemplated.
  • the controller 46 may be configured to receive position data PD from the localizer 60 associated with the tool 42 within the field of view FV by tracking a base tracker (not shown) attached to the robotic arm 36, such as by monitoring the position and/or orientation of the base tracker, with the base tracker being registered to the manipulator coordinate system MNPL, and with encoder data ED being additionally used to determine a position of the reference point RP in the manipulator coordinate system MNPL.
  • the controller 46 can then compare the current position of the checkpoint 110 in the manipulator coordinate system MNPL relative to the current position of the reference point RP to the stored, possible positions of the checkpoint 110 based on its stored relationship to the reference point RP, e.g., against the identification data ID stored in the memory 48, to determine the identity of the tool 42.
  • position data PD associated with the tool 42 may be at least partially determined using encoder data ED from the robot controller 56.
  • the present disclosure is also directed toward a method of assisting the surgeon (or another user) in performing the surgical procedure with the surgical system 30.
  • the method comprises different steps, including attaching the tool 42 having the checkpoint feature 110 to the surgical robot 32, and sending the first interface image IM1 to the monitor 68M prompting the surgeon to position the distal tip 50D of the pointer 50 at the checkpoint feature 110 of the tool 42.
  • the method also comprises tracking the pointer 50 with the localizer 60 to determine position data PD associated with the pointer 50, identifying the tool 42 by comparing the position data PD from the localizer 60 with stored identification data ID, and sending a second interface image IM2 to the monitor 68M presenting the surgeon with the identity of the tool 42.
  • inventions of the surgical system 30, end effector 40, tools 42, and methods described herein afford advantages in connection with a broad number of medical and/or surgical procedures including, for example, where surgical robots 32 are utilized in connection with total hip arthroplasty.
  • the embodiments described and illustrated herein are configured to facilitate identification of different variations of tools 42 in one or more toolsets 78A, 78B quickly, reliably, and efficiently while, at the same time, affording the surgeon with guided assistance in carrying out different types of surgical procedures.

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Abstract

Un système chirurgical pour aider un utilisateur à effectuer une intervention chirurgicale sur un site chirurgical, comprenant un outil ayant un point de contrôle, un pointeur ayant une pointe, et un localisateur pour déterminer une position du pointeur dans un champ de vision. Une mémoire comprend des données d'identification associées à une pluralité d'outils. Un dispositif de commande est configuré pour inviter l'utilisateur à positionner la pointe au niveau du point de contrôle, pour recevoir des données de position provenant du localisateur associé au pointeur dans le champ de vision, pour comparer des données de position associées au pointeur par rapport aux données d'identification de la mémoire pour déterminer une identité de l'outil, et pour présenter à l'utilisateur l'identité de l'outil.
PCT/US2019/018500 2018-02-19 2019-02-19 Systèmes chirurgicaux et procédés d'identification d'outils guidés par des robots chirurgicaux WO2019161363A1 (fr)

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EP3755259A1 (fr) 2020-12-30
US20190254756A1 (en) 2019-08-22
AU2019222578A1 (en) 2020-09-03
US20230086467A1 (en) 2023-03-23

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